Health group urges overhaul of US food safety system

Apr 30, 2008 (CIDRAP News)  Calling the US food safety system antiquated and disjointed, a public health advocacy group today urged a major overhaul to make the system stronger, more coherent, and better attuned to today's major threats.

The Trust for America's Health (TFAH), a nonprofit, nonpartisan group based in Washington, DC, issued a report citing a long list of problems, including severe underfunding at the Food and Drug Administration (FDA), obsolete laws, a largely reactive approach to safety problems, and the spreading of food safety responsibilities among 15 different federal agencies.

"The major problem is that no one person is in charge," said Jeff Levi, PhD, at a news conference about the report, titled Fixing Food Safety: Protecting America's Food from Farm-to-Fork.

"We really haven't paid attention to giving the food safety agencies, the FDA and USDA [US Department of Agriculture] in particular, the tools to do the job we expect them to do," said Michael Taylor, research professor of health policy at George Washington University and former administrator of the USDA's Food Safety and Inspection Service (FSIS).

Among near-term steps to address the problems, the report calls for doubling the FDA's food safety funds over the next 5 years and putting one person in charge of the agency's food safety programs. For the long term, the nation should move toward consolidating all federal food safety programs in one agency, the group recommends.

Outdated lawsOutdated laws are to blame for many of the kinks in the food safety system, according to TFAH. Taylor said the basic principles for regulating animal slaughtering were established in 1906, and the tools for addressing microbial pathogens in food and regulating food imports were set in 1938.

For example, said Levi, "FSIS agents are required to visually inspect every single one of the 8 billion chickens slaughtered each year. Given that the major threat is Salmonella, an invisible microbe, it's clear that these expensive procedures are outdated."

Taylor said existing laws focus mainly on reacting to safety hazards rather than preventing them, and they have promoted the fragmentation of responsibility. The fundamental split is between the USDA, which regulates meat, poultry, and processed egg products, and the FDA, which regulates everything else. Other agencies involved are the Centers for Disease Control and Prevention (CDC), which monitors foodborne illness outbreaks, and the Environmental Protection Agency (EPA), which deals with pesticides and toxic chemicals.

Frozen pizza offers a prime example of how responsibilities are oddly divided, the report notes. The FDA regulates frozen pizzaunless cooked meat or poultry toppings make up 2% of the ingredients or more, in which case the FSIS is responsible. The FSIS inspects plants making pepperoni pizza every day, whereas the FDA inspects cheese pizza plants an average of once every 10 years.

Taylor said food safety responsibilities are also fragmented within the FDA, in that the Office of Regulatory Affairs, which manages inspectors in the field, is not accountable to the Center for Food Safety and Applied Nutrition (CFSAN) and the Center for Veterinary Medicine (CVM).

Imbalanced fundingWith the divided responsibilities comes imbalanced funding, according to TFAH. It is estimated that 85% of foodborne illness outbreaks involve FDA-regulated products, but the FDA receives much less food safety money than the USDA. This year, for example, FDA's food safety allocation is $619 million, compared with $1.07 billion for the USDA, the report says.

TFAH officials also said food safety generally takes a back seat to drug and medical device safety at the FDA.

Further, the FDA has received no additional funds to combat deliberate contamination of the food supply since the Bush administration called for a national food-defense effort in 2004, whereas the USDA has received $150 million, according to the report.

TFAH offers several general recommendations for building a "modern food safety system":

Shift from "limited end-product and processing plant inspections" to an emphasis on preventing illnesses throughout the food production process and supply chain.

Conduct research on emerging threats and up-to-date ways to contain them.

To make imported food safer, give food safety agencies the authority and resources to educate foreign regulators and producers about US food safety standards, to require food importers to show the standards are being met, and to inspect foreign establishments and food shipments.

A first step toward those goals is to at least double the FDA's food safety funding in the next 5 years, the report says.

"While it's very important to look at the system as a whole, it's really FDA's program that's in most dire need of help, due to its dwindling resources," said Taylor. The agency has lost 20% of its science staff and 600 food inspectors in the past 3 years, the report says.

Report coincides with FDA hiring planThe TFAH report happened to coincide with today's FDA announcement that it plans to fill more than 600 new positions and "backfill" 700 others over the next several months. The new staffers, including biologists, medical officers, statisticians, and investigators, are needed to implement the FDA Amendments Act of 2007 and the Food Protection Plan and Import Safety Plan announced last November, the FDA said in a news release. The announcement didn't say how many of the positions are related to food safety.

Commenting on the FDA announcement, Levi told CIDRAP News, "It appears that a significant portion of those are going to food safety, and thats very good. The question is whether the budgetary resources will be there to sustain those positions over time, because FDA hasn't received increases that would sustain those."

Besides boosting FDA funding, the nation needs to raise the profile of food safety programs within the Department of Health and Human Services (HHS), TFAH advises.

"FDA's food functions should be brought together under unified leadership, with a single official, reporting to the [HHS] Secretary, focusing full time on, and being responsible and accountable for, providing food safety leadership nationally and internationally," the report states.

Further, it says the government should work toward assigning all food safety functions to a single agency for the sake of effectiveness, responsibility, and accountability. The agency should oversee not only regulation and inspection but also research and surveillance.

The single agency should include the FSIS; the food functions of the FDA, including CFSAN, CVM, and the FDA's field staff; and the food safety aspects of the EPA's pesticide program.

In addition, the placement of the CDC's foodborne disease surveillance program should be reviewed, the report says. The surveillance program needs to be better aligned with other federal, state, and local efforts in the interest of more timely reporting and improved detection and control of outbreaks.

Finally, TFAH recommends that states should be encouraged and given incentives to comply with two voluntary sets of food safety standards, the FDA Food Code and the National Retail Food Regulatory Program.

Levi said various bills now in Congress address parts of the TFAH recommendations, but passage of major legislation in this session is unlikely, in his view.

"I'd say the first and most important thing Congress can do is address the funding shortfall at FDA, and that doesn't require legislation," he said.